Dr Ike Okwesili’s Thoughts on NMA Stamp
Revisiting the issue of NMA seal is important to me because the medical profession in this country has to heal itself if the government is not interested.
There is no policy that is perfect in the world but I have learnt in life that the easiest thing to do is to find fault. I have learnt not to criticize except I have an alternate plan on that particular issue.
The issue of of seal is quite timely and after a lot of deliberation and tinkering with Stamp versus seal and modifications this was settled for. It wasn’t taken from the beer parlour joint under the influence of something, It took men’s brain and time.
The seal becomes important if we saw the Medical Reports that made its way to NYSC camp last year, Some coming from “first Generation teaching hospitals”, with young ladies suffering from BPH and signed by a “doctor”. Some were the same letter with different patients name on 2different letter head in different states.
It is common to see patients or friends calling a doctor to request for a medical report because he has been advised to get one by his office even if it means forging, so the general public knows reports can be cooked by even compromising genuine doctors.
I had a publication with some doctors in Harvard Medical School titled *Traditional Bone setters and Contemporary Orthopaedic Fracture Care in a Developing Nation: Historical Aspects, Contemporary Status and Future Directions*published in The Open Orthopeadic Journal in 2012.
In our pre acceptance review one of the authors believed the Orthopedic surgeons in Nigeria is in contest with TBS. yet these people are even doing referral and are regarded as doctors by the public in Nigeria and our citizen abroad, and continue to create the kind of problems pointed out by Dr Odunubi in his This Day interview.
I had to start re-education and getting him to know that here, for every 10 surgeries in Nigeria 8 were from TBS complications. In real “business” sense they keep us in business It is time the public see the Genuine doctor as the man with the seal as the lawyers are seen.
Those of us who indulge in unnecessary oversea referral that cause undue medical tourism should put their seal to it. It should no longer be business of telling a young medical officer to do the unnecessary referral for the popular guy.
I have been approached by a doctor for a referral to India for a businesses man who had De Quervain tenosynovitis insisting he will pay, I had to tell him that it is like referring incision and drainage, the truth was the man wanted to go on vacation with the wife and needed a smoother visa and a doctor was willing to co opt me. I had to let him tell the man that he won’t get the report from me for 5million naira.
A consultant physician told me last week that he has a patient that needed my referral to US for back pain surgery in a patient who should present to me and I will review and tell him what he needed. The scenario is endless and the public knows that these reports can be cooked on request yet we expect a better deal from them.
Recently I sent a patient to the physiotherapist for Quadriceps strengthening and range of motion exercises of knee and the physiotherapist referred to a consultant radio oncologist because the patient had an ultrasound suggestive of a tumor in the quadriceps Muscle, this was a patient with some quadriceps fibrosis from infection. Surprisingly the residents in the unit acted on the physiotherapists referral and started taking history in the same case file that has all the patients documentations.
Chief nursing officer CNOs refer to specialist clinics and some residents and even consultants honor it. One of my resident has had to express surprise at my comment on this type of referral. I let him understand the implications and to avoid the patient suffering he should indicate that the patient should have folder opened on a clean sheet as emanating from him and not to file referral from a CNO in the patient folder in a teaching hospital.
Even Admin staff refer patients in some hospitals and we file it. When other professions in the health sector have finished equating themselves to us in our work place and move to National Assembly to legalise their conquered terrain, we will start complaining.
A friend genuinely told me the seal would have covered prescription and I agreed but explained in life you choose the wars you can win easily and expand gradually. When we start with reclaiming our traditional territory it will be easier to conquer and evil that has been accepted as a norm in a society.
I expect ways of making this bold move by NMA better as the years go by rather that calling for solution to more pressing issues; *what can be more pressing than solving fundamental problem*. It is easy to criticize but that will be like my saying that this Whatsap group for NMA NEC drains my phone battery forgetting that it equally puts me on real time with the best doctors in Nigeria. Best Regard.
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